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Jonas Dahlberg

Physician

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A Nested Case–Control Study on the Risk of Surgical Site Infection After Thyroid Surgery

Author

  • F. A. Salem
  • M. Almquist
  • E. Nordenström
  • J. Dahlberg
  • O. Hessman
  • C. I. Lundgren
  • A. Bergenfelz

Summary, in English

Introduction: It is unclear if antibiotic prophylaxis reduces the risk of surgical site infection (SSI) in thyroid surgery. This study assessed risk factors for SSI and antibiotic prophylaxis in subgroups of patients. Method and design: A nested case–control study on patients registered in the Swedish National Register for Endocrine Surgery was performed. Patients with SSI were matched 1:1 by age and gender to controls. Additional information on patients with SSI and controls was queried from attending surgeons using a questionnaire. Risk factors for SSI were evaluated by logistic regression analysis and presented as odds ratio (OR) with 95% confidence interval (CI). Results: There were 9494 operations; 109 (1.2%) patients had SSI. Patients with SSI were older (median 53 vs. 49 years) than patients without SSI p = 0.01 and more often had a cancer diagnosis 23 (21.1%) versus 1137 (12.1%) p = 0.01. In the analysis of patients with SSI versus controls, patients with SSI more often had post-operative drainage 68 (62.4%) versus 46 (42.2%) p = 0.01 and lymph node surgery 40 (36.7%) versus 14 (13.0%) p < 0.01, and both were independent risk factors for SSI, drain OR 1.82 (CI 1.04–3.18) and lymph node dissection, OR 3.22 (95% CI 1.32–7.82). A higher number of 26(62%) patients with independent risk factors for SSI and diagnosed with SSI did not receive antibiotic prophylaxis. Data were missing for 8 (31%) patients. Conclusion: Lymph node dissection and drain are independent risk factors for SSI after thyroidectomy. Antibiotic prophylaxis might be considered in patients with these risk factors.

Department/s

  • Surgery (Lund)
  • Endocrine and Sarcoma Surgery

Publishing year

2018-08

Language

English

Pages

2454-2461

Publication/Series

World Journal of Surgery

Volume

42

Issue

8

Document type

Journal article

Publisher

Springer

Topic

  • Surgery

Status

Published

Research group

  • Endocrine and Sarcoma Surgery

ISBN/ISSN/Other

  • ISSN: 0364-2313